Health sciences education continues to evolve today as future physicians will encounter patients in quite different healthcare contexts from the present. Exponentially expanding medical knowledge requires physicians to update what they know, shared Dr Khalil Yousef, Associate Professor – Health, School of Humanities, Social Sciences, and Health, University of Wollongong in Dubai (UOWD). In an interview, he highlights the current gaps in health sciences education and the importance of continuous training. Excerpts:

What are the current gaps in traditional health sciences education?

Evidence shows that patient safety depends on the quality of the workplace culture. In particular, the working relationship among all multidisciplinary healthcare team members (physiotherapists, pharmacists, social workers, doctors and nurses). The traditional approach to the education and preparation of healthcare professionals has been likened to ‘silos’. Rarely do students from different disciplines get the chance to learn with and from each other until they have graduated. Once they graduate, they are then expected to work together harmoniously. Successful teamwork, however, depends on understanding and, in turn, respecting what/how each team member contributes to achieving the primary goal: high-quality patient care and outcomes. The limitations of this traditional approach to the education of the healthcare workforce resulted in a global effort to redesign the curriculums to include opportunities for the different professional groups to learn and practice together throughout their undergraduate education. 

How important is it for doctors to get training in clinical leadership, patient quality/safety, and digital health informatics?

It is very essential! All undergraduate curricula for medical education now include knowledge and skill development opportunities to ensure a level of competency in each of these areas. Essential to remember is the need to review this knowledge and skill on a regular basis through well-structured programmes of performance  evaluation and accompanying continuing education opportunities.

Dr Khalil Yousef

What are the top five trends shaping the future of health sciences?

The top five trends include artificial intelligence, digital informatics, effective utilisation of big data generated by electronic medical records, escalating costs resulting in a significant drain on the GDP of any country and movement of care away from hospitals and into home/community.

What’s the biggest challenge in facing these trends?

It is important to educate healthcare professionals who have been working in the healthcare system for several decades and upskill them to adapt successfully to this rapidly changing workspace.

What does the future of health sciences education look like to you?

Ideally, individuals interested in developing a career in medicine/health should be given the opportunity to learn and experience the scope of different disciplines in health during their first years of undergraduate education. This could be in the form of all students having to complete a foundation year in Health Science. During this time, they get to confirm whether or not a career in allied health, medicine or nursing is what they expected and, therefore, want before embarking on the additional years of study.

What is UOWD doing to deliver the future of health sciences education?

We are actively engaging with key stakeholders throughout the UAE health system that provides us with the information needed to ensure that our curriculums adapt to and meet the industry’s needs.

 

This article appears in the Daily Dose 2023. Read the full issue online today.

Back to Management

Healthcare worldwide is constantly evolving due to changes in the fields of medication and diagnostics, but also because of the fast-moving nature of global economies which makes time a priority factor when considering treatments and diagnoses.

This continuing evolution is one of the main drivers of technological innovation in healthcare, as it leads to improved patient outcomes, increased access to the best available care, reduced costs and better efficiency in the delivery of healthcare services. It also directly impacts social healthcare initiatives and infrastructure development plans.

The recent Arab Health 2023 helped showcase innovation from around the world, and while it is difficult to choose from the hundreds of unique new products and solutions, today we showcase six of the most innovative ones we came across.

UAE becomes the first country outside North America to deploy leadless pacemakers

The UAE recently became only the third country in the world and the first outside North America to use what is known as the leadless pacemaker, a revolutionary innovation to the critical care device. Presenting the innovative device – created by the US giant Abbott - to the public at its stand at Arab Health 2023, Emirates Health Services showcased its benefits and evolution via 3D displays.

Unlike traditional pacemakers that require an incision via invasive surgery to implant a power generator near the collarbone, connecting to the heart muscle via wires, the leadless pacemaker is a miniature device inserted via catheter in the thigh vein and then implanted directly into the heart.

Advanced ventilation for emergencies in the palm of your hand

Hersill Medical Devices displayed its VITAE®40 transport and emergency ventilator at the show, which places the power of a full breathing apparatus set into a portable device you carry in your hand. The VITAE®40 is an electronic ventilator designed to provide advanced respiratory support to patients during intrahospital transfers, from ICU unit to operating rooms or to diagnostic imaging areas. It is also designed to provide service in a mobile ICU.

The device, launched just before the pandemic, became a key innovation that helped provide for on-the-spot respiratory needs in patients whether or not they were diagnosed with COVID-19. Despite being a recent innovation, it has already been deployed across parent country Spain with thousands of units in use since the pandemic. It provides high-flow oxygen therapy, CPAP, Non-Invasive Ventilation and Invasive Ventilation with performance and ventilation modes similar to those offered by ICU ventilators. It also has specific ventilation modes for CPR manoeuvres.

Virtual Reality as easy as 1, 2, 3

While many companies exhibiting offer virtual reality (VR) solutions for hospitals, clinics, diagnosticians and HCPs, a one-stop ‘do it yourself’ VR system that can be customised by use case is definitely a game changer. VRpatientsTM is a powerful no-code medica education sim-builder that empowers specialists to build any simulation to meet medical education needs. The system allows the user to create life-like clinical experiences that meet all nursing accreditation education standards, a diversity of avatars that are physiologically responsive and medically accurate and features different scenarios that can be deployed via a desktop computer or a mobile phone.

The objective of the VRpatients offering is to help with faster training of practitioners, reduce errors, and engage in unique, differing daily scenarios to keep teams at the top of their game. The plug-and-play options that are similar to using popular slide show creators and drag-and-drop design tools make it easier and faster to use than having to get unique designs and scenarios built by agencies that can cost multiple thousands of dollars. Unlike civilian game designers who build single-use simulations for tens of thousands of dollars, the VRpatients’ EMS educator option allows you to design your sims, deploy them remotely and measure competencies related to local protocols and national guidelines.

Telemedicine in HD

Poland’s medVC showcased their unique telemedicine education solutions and diagnostic training solutions. Their key offering to the industry is high definition (HD) connectivity combined with the multi-picture-in-picture feature, which unlike other solutions in the market allows HCPs and healthcare trainers to display live streams of multiple surgical procedures as well as multiple recorded sessions at the highest possible resolution. Deployment is possible on a range of devices, including medVC’s proprietary medical carts that feature full HD screens and PTZ camera, video inputs for AV devices in the operating theatre (endoscopes, microscopes, Da Vinci robots, etc), medical touch screen monitor and a wireless headset, microphone and speaker; mobile phones, video portals online, a standalone terminal that can be used in medical universities as well as HCP offices.

The solution offers two transmission modes, interactive dialogue and streaming-only. This allows for it to be deployed at conferences that offer live surgery sessions, interactive remote consultations by doctors away from hospitals as they can view a patient’s entire anatomy and disease issue in HD, battlefield deployment for use under difficult combat conditions (the system is compatible with NATO standards) and remote surgeries supervision for difficult to access geographic areas.

Rehabilitation beyond the status quo

Patients who have suffered from strokes or require extensive physical therapy and rehabilitation usually find themselves walking the same path, literally, as many around the world: a long journey of minute, slow steps on flat surfaced gait platforms.

However, help is at hand. DPE Medical Ltd with Leader Healthcare displayed its innovative new improvement on rehabilitation platforms with the DST8000 systems, featuring tailor-made models targeting all three essential functions for a patient’s mobility: walking, climbing stairs and negotiating slopes. With a click of a button, the flat platform converts into a slope or stairs with adjustable heights and incline degrees, adjustable to the current and evolving abilities of patients.

The built-in monitoring systems allow doctors to diagnose the source of impairment and create an accurate treatment plan, as well as keep track of the patient’s progress without ever leaving the clinic. One single device saves cost, space and time by replacing multiple units of fixed stair devices, slopes, parallel bars and other gait analysis solutions.

Healthcare in the clouds

Faster access to data, universally deployable across devices and consoles, instant analytics for quicker diagnoses, all of this is the result of a boom in healthcare-based cloud computing. Arab Health saw many companies showcase a variety of cloud solutions, with a few pushing the envelope of innovation with evolving tried and tested hardware to take advantage of this.

seca, the medical measuring giant in business since 1840, displayed its new generation of body composition analysis devices which go beyond commercial use commonly seen in nutrition and fitness clinics to more medical specialisations, including portable and home-based devices. Unlike traditional measurement devices of this nature, the seca innovation allows for more than just height, weight and BMI data capture but also uses bio-impedance analysis to not just measure body components but also to calculate them using precision formulas. All the data is then uploaded into the cloud solution and deployed with analytics and insight to diagnosticians and the patient, easily accessible at any time, saving time, money and travel.

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This article appears in the Daily Dose 2023. Read the full issue online today.

< Back to Technology

Telemedicine is the umbrella term for many different forms of medical provision over distance and sometimes also asynchronous.

In general, we differentiate between teleconsultation, being the interaction between a medical professional and a patient (doc2pat), and teleconsult, meaning the interaction between two medical professionals (doc2doc). In radiology, for example, a technician performs the imaging and a (specialised) radiologist performs the appraisal or international multidisciplinary tumour boards (tele-conferencing). It may also be the telephonic or video communication between nursing staff and physicians, nurse-conducted outpatient visits and nurse-led anaesthesia.

History of telemedicine

The first scientific publication of a telemedical consultation was in the year 1879, titled ‘Practice by telephone’ — just three years after Alexander Graham Bell had filed a patent for the telephone. Since then, telemedicine has been a part of the medical profession in one way or another. Many developing countries like India have already embraced telemedicine in various clinical settings decades ago.

Challenges of modern healthcare systems

In countries with long traveling distances to medical facilities and difficult topography, like for example in Australia, Scandinavian countries or even the US, telemedicine is one of the only means to provide professional medical healthcare. And in various European Anglo-Saxon countries telemedicine has developed to be one of the pillars of primary and specialised healthcare in the last two decades. The COVID-19 pandemic in the last two years has lowered many regulatory and/or habitual barriers to telemedicine. In many countries the development of digitalisation in medicine (telemedicine) has been rather slow in comparison to other industries. This mostly due to habits of the population in the way medical services are consumed, regulatory barriers and often missing billable tariffs to be able to establish tele-medical services accordingly.

The telemedical market

The potential applications for telemedicine have reached an inflection point in health care. Mobile smartphone ownership in the US has reached >90 per cent in the 18- to 49-year-old population the same applies for most European countries, mobile computing and cellular phone technology have combined high-fidelity cameras and telecommunication hardware to make video teleconferencing seamless, and patients are more accustomed to interfacing with their healthcare systems via digital telecommunications including e-mail, mobile phone, and electronic patient portals. Recent market analyses project the global telemedicine market to grow to US$130.5 billion by 2025, and yet, anaesthesiology is the specialty least engaged with telemedicine-based clinical work.

 Dr. Andrea Vincenzo Braga, MD, MBA

 

Digitisation boost through COVID-19 pandemic

The COVID pandemic has forced medical institutions to rethink many processes and to push digitisation, especially in patient interaction. Various (medical) processes before and after hospitalisation and/or day-stay interventions can be virtualised. For example, pre-interventional patient history taking end it says your logic premedication consultations, especially for healthy patients can well be done via telephone - or even better - video-consultation. The same thing applies to post-interventional monitoring and follow-up consultations. Here by receipt that there is a very intelligent location of medical/physician resources and time, and it saves patience a lot of unnecessary travel time.

There are of course limitations, especially with multi-morbid patients and patients with limited mental capacities, language difficulties, or inability to operate technical equipment. On the other hand, the consulting physician must be sure that he is able to assess the patient’s condition adequately and concise documentation is mandatory. In case of any doubts that physical consultation must follow.

Telemedicine in anaesthesiology

Anaesthesiologists have had over a decade-long experience with telemedicine for preoperative consultation. Identification of preoperative risk factor and pre-anaesthesia visits are widely accepted as the gold standard of care for elective surgery and are essential for reducing morbidity and mortality. 

A boost came with COVID-19 forced public health restrictions thus requiring a careful balance between ensuring best preoperative medical practices and maintaining safety from infection by minimising patient face-to-face attendance in the hospital or clinic. Based on the successful implementation of telemedicine in other medical specialties and its feasibility in the preoperative context, a study with a total of 2,805 patients, which were assessed in the preoperative anaesthesiologic assessment clinic between July 2020 and March 2021 aimed to develop, implement, and evaluate a high-quality virtual preoperative anaesthetic assessment process.

In Switzerland and Austria there have been very good experiences in performing pre interventional telemedical consultations, also known as telemedicine anaesthesia consultation (TCAD), for day-stay and interventions requiring hospitalisation.

Tele-anaesthesia involves anaesthesiologists using technology to provide patient care remotely before, during and after surgeries and procedures, including the management of anaesthesia and observation during patient recovery. This as well for university-level support for rural hospitals as in pre-operative settings for standard operations on healthy patients.

Advantages and limitations of telemedicine

Telemedicine is a vast subject and has many different aspects and challenges: technical, legal, cultural, behavioral, concerning patients, doctors/nurses and institutions. Even though the number of publications about telemedicine, not only in anaesthesia and intensive care settings has dramatically increased, data on the clinical effectiveness and cost-effectiveness of most telemedicine applications is still limited, as are the clear arguments about benefits and drawbacks of telemedicine.

Many potential benefits of telemedicine can be emphasised, especially improved access to information; provision of care not previously deliverable, notably in rural and less developed areas; improved access to medical services and increasing care delivery; improved professional education; and reduction of healthcare costs-increases, and most of all intelligent allocation of medical professional resources, not to forget patients facilitated access to high quality medical services even with limited mobility or other handicaps. Although telemedicine clearly has a wide range of potential benefits, it also has some disadvantages. The main ones that can be envisaged are a potential weakening in the relationship between health professional and patient; a breakdown in the relationship between health professionals; issues concerning the quality of health information; and organisational, legal bureaucratic difficulties, and last but not least, reimbursement uncertainty. On balance, the benefits of telemedicine are substantial, assuming that more research will reduce or eliminate the obvious drawbacks. Face-to-face interactions remain a favourable option of patient-medical professional interaction, where reasonably applicable and possible.

The future of telemedicine

As telemedicine programmes develop within the perioperative arena, it is imperative for institutions to share knowledge, successes, and pitfalls to improve the delivery of care in today’s technology-driven medical landscape. 

Moreover, telemedicine may improve access to physicians for patients with mobility problems, such as patients with disabilities, fragile patients, or older patients, and could ideally promote equity of access to healthcare and quick patient engagement at a reduced cost.

As medical resources become scarcer, patients demand rise, high-end technology becomes more accessible and affordable, mobile devices widespread, behavioural change in the population with higher acceptance to engage in medical services using communication technology medical professionals and medical institutions should fathom and embrace the possibilities of widening their service offer to patients reasonably combining virtual and real medical provision to the benefit of a larger patient population. 

Further, data-driven studies should accompany telemedical initiatives and services to prove process efficiency, patient safety, intelligent use of medical personnel resources, patient-time and economic value. Investigating benefits by avoiding transport, unclog consultations in hospitals, and avoiding absences from work for traditional consultations are some of the advantages of this new method of consultation can be of further value.

This article appears in the Daily Dose 2023. Read the full issue online today.

In the past, when an individual complained of chest pain, they would be tested to check if they were suffering from heart disease and would be recommended surgery. The surgeon would then provide rough estimates regarding recovery times based on “herd” medicine or a generalised approach. However, today, healthcare is moving away from that to a more personalised approach that looks at other factors, such as weight and physical activity, to determine a patient’s recovery rate.

In an interview, Dr. Mohamed Rehman, Chair, Department of Anaesthesia and Pain Medicine, Johns Hopkins All Children’s Hospital; Prof, Anaesthesiology and Critical Care, Johns Hopkins University School of Medicine, St Petersburg, Florida, U.S., explained that thanks to the volume of data available today, a baseline could be created for that individual and if they don’t recover within the timeline ideal for them, doctors will call them in for more follow-ups. The model creates an individualised digital signature of people, and by leveraging tools such as AI and machine learning, doctors will be able to diagnose quickly “One size does not fit all, and we are moving away from herd medicine to precision medicine. To achieve this, we have launched a human digital project that collects all the data about a person and creates their digital twin. Hence, it is easy to observe if there is any drastic change and try to keep the digital twin as close to normal as possible,” he shared.

Excerpts from the interview:

Tell us about the human digital twin project.

The digital twin is a concept that has been used by NASA, IBM, and several other industries. Through our human digital twin project, we monitor patients and employees in real-time. We are following patients who have gone through spine surgery, sickle cell and heart disease patients, etc. We are also following our employees in the operating room and ICUs. We monitor their steps, sleep, heart rate, variability, and saturation, among other factors. In addition to that, we do psychological testing with internet-based questionnaires every month. Based on all this information, we can see their baseline and observe if their stress has increased.

Dr. Mohamed Rehman

Can digital twins reduce the time people spend in hospitals and bring down the cost of care?

Thanks to the technology, we have had patients we would not have recognised, with problems being picked up much earlier. We can also differentiate patients into three groups - early, normal and late recovery patterns. So, for instance, if the early recovery pattern patient does not recover in two weeks, we get worried. If we start applying this model to a whole population, we will be able to move the needle from treatment to prevention, and that’s going to be a significant cost saving.

 

This article appears in the Daily Dose 2023. Read the full issue online today.

In light of the pandemic, the healthcare sector, like any other industry, had to reassess its priorities and make constant adjustments to suit the shifting patterns. Among the difficulties it faced was the complete shutdown of medical travel due to travel restrictions and patients’ fear of hospital visits.

Fortunately, as we slowly emerge from the pandemic, medical travel is again gaining traction. In the UAE, important decisions taken in the early days to curtail the virus and the effective preventive measures put in place have catalysed the comeback. The country has been at the forefront of creating a reliable ecosystem favourable for medical travel to thrive again.

Recent research has found that the global medical tourism industry is estimated between US$35 to US$55 billion, with 12-14 million travellers taking medical trips each year for treatments including cosmetic surgery, reproductive health, dental and orthopaedic, amongst others. Reportedly, the growth rates for medical travel remain stable between 7-9 per cent, with the wellness tourism market expected to grow much faster at 20 per cent per annum.

The Asia-Pacific’s medical tourism industry is expected to grow at the highest rate., boasting advanced healthcare infrastructure and a skilled workforce to cater to international patients. Furthermore, the rise in the number of international health insurance providers is another factor that has contributed significantly to the growth of the global medical tourism industry.

Spotlight on the UAE

The UAE is expected to witness the fastest growth in the Middle East, supported by mandatory insurance in Dubai, expanding medical travel, increasing population and medical inflation. The country’s medical travel industry is expected to reach US$53.5 billion by 2028, with Dubai having a majority share of the medical travel market. The influx of international patients is expected to grow by 20 per cent from 2022.

The country is renowned for offering state-of-the-art services in plastic surgery, orthopaedics and sports medicine, ophthalmology, preventative healthcare, dental surgery, wellness, dermatology, and aesthetic procedures, among others.

The UAE’s decision to make private hospitals COVID-19-free was one of the several factors instrumental in bringing about this much-needed change. Compared to other preferred medical tourism destinations, a clear difference can be seen between the UAE’s approach to handling the pandemic, which has given the country a unique advantage. The structured approach that the government took made it a leading example for the rest of the world.

Furthermore, these measures have been crucial in building confidence among international patients. Moreover, major global airlines have returned to business as usual, while the hospitality industry is continuing to implement stringent hygiene control.

Also, most shopping malls, F&B outlets and entertainment industries are back in full swing, creating a much-needed tourism ecosystem. All these factors are boosting medical travel and creating an environment conducive to industry growth.

Looking at the Northern Emirates, last year, RAK Hospital in Ras Al Khaimah won two prestigious awards from World Medical Council (WMC) at WMC Excellence Awards 2022 in Dubai. Bagging the ‘Medical Tourism Hospital of The Year’ award, the healthcare institution was recognised for its commendable efforts in promoting UAE as a medical tourism destination across the globe and establishing the hospital as a preferred medical tourism destination.

At RAK Hospital, we have always worked in line with the UAE’s vision. With a department exclusively dedicated to foreign patients, we have created a vast network that ensures a complete, holistic and satisfying experience for patients from start to finish, both in terms of a welcoming environment and world-class treatment. Over the years, RAK Hospital has represented UAE on international platforms to generate medical travel into the country successfully. Moreover, it has also gained a reputation for successfully handling critical emergency surgical cases flown into the country, further cementing UAE on the medical travel map. In fact, we witnessed an increasing number of medical tourists and inquiries at RAK Hospital last month.

Regulatory initiatives

A collaborative approach across private and public healthcare providers and the UAE government is increasing, which is expected to drive better health outcomes and ensure the sustainability of the health ecosystem. Regulatory authorities and governments are working towards increasing access to accurate real-time health information and services for better planning of healthcare infrastructure and workforce and increasing better health outcomes.

For instance, the Dubai Health Authority (DHA) has launched the “Dubai Health Experience” as the world’s first medical tourism portal to boost medical travel. The Department of Health Abu Dhabi (DoH) and the Department of Culture and Tourism – Abu Dhabi has also launched the Abu Dhabi Medical Tourism e-portal. These portals allow visitors to book medical procedures and take advantage of discounted airfares, visas, medical insurance, hotel stays, leisure activities and more.

Leveraging telemedicine

As a result of the increasing adoption of “connected care”, technological advances have changed from the traditional asset-heavy hospital-related developments to pioneering medtech devices; to new sector niches, such as digital health, including its subcategories mobile health, wearable devices, telehealth and telemedicine, and personalised medicine.

The emergence of telemedicine as an essential communication tool has been a further boon for the medical travel industry. With the world shifting to virtual platforms due to the tough travel restrictions, telemedicine emerged as one of the most important means to establish regular contact between patients and healthcare professionals.

There are two primary areas of telemedicine:

• Teleconsultation enables patients (alone or accompanied by healthcare professionals) to consult a doctor remotely by means of technological tools.
• Telemonitoring enables a medical professional to interpret data collected in the patient’s living environment remotely and in real time.

I have always strongly felt that most medical tourists could opt for telemedicine for the first few initial consultations and procedures. To achieve this, we offer free teleconsultation to familiarise medical tourists with this route. At RAK hospital, our doctors actively engage with telemedicine patients worldwide and offer them best-in-class consultations, further cementing confidence in the tool. With immense growth opportunities available, telemedicine is already on the path to becoming a profit-making prospect.

Dr. Raza Siddiqui is the CEO of Arabian Healthcare Group.

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This article appears in the Daily Dose 2023. Read the full issue online today.

Over the last few years, cellular immunotherapy has become integral to treating certain cancers. The therapy uses cells of the immune system to fight cancer. Today, new treatments are continuously being tested and approved. Moreover, new ways of working with the immune system are being discovered rapidly.

As part of the Internal Medicine conference today, Dr Marcos de Lima from Ohio State University (OSU) Wexner Medical Center, Columbus, Ohio, US, will be shedding light on advances in cellular immunotherapy for the treatment of cancer. “l will also discuss non-cancer indications, as it is a forward-looking treatment option. Cellular immunotherapy is becoming established in some cancers like lymphoma and leukaemia and has the potential for autoimmune diseases, HIV, or anaemias. The field is continuously expanding,”

Excerpts from the interview:

When do you think cellular immunotherapy will become mainstream?

The industry is growing, and we are going to see a lot of new therapies approved. Even the US FDA has been approving immunotherapy treatments over certain periods. So, I think some of the approaches, besides the ones already FDA approved, will become approved over the next decade.

What role is technology playing in fast-tracking these therapies?

Technology plays a huge role in making certain time-consuming and costly processes more affordable. Furthermore, genetic engineering tools are becoming very accessible to modify cells. So, technology is changing this field a lot.

Is there any particular case study that you would like to highlight?

One topic that is of particular interest is the local manufacture of cells. At present, you collect the cells from one patient, ship them to a centralised company that manufactures them, and then send back the product. Although this paradigm works reasonably well, the prices are still very high. We are attempting to do the opposite and manufacture the cells locally to reduce the costs.

What do you think are going to be some of the biggest healthcare trends?

Traditionally, cancer was treated with radiation therapy, chemotherapy and surgery. These used to be the three main approaches for its treatment. Now, we are seeing immunotherapy, which takes advantage of the immune system, as a strong fourth pillar. I think it is one of the significant trends we will see in the next decade.

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This article appears in the Daily Dose 2023. Read the full issue online today.

The Healthcare Transformation Zone at Arab Health evolves every year to bring forth the latest cutting-edge technology in healthcare. This year, it welcomed the Intelligent Health Pavilion, which is redefining the care continuum with revolutionary technology and equipment that enable seamless digital integration.

“There is a lot of technology in healthcare and the problem is that a lot of the executives in the hospital and clinicians simply do not have enough time to understand it. It is important that they are given opportunities to learn and adopt this technology so that we can save lives,” said Harry Pappas, Founder and CEO of the Intelligent Health Association.

The Association is armed with a mission to provide unbiased information to give healthcare professionals an all-inclusive, global platform of knowledge and inspiration to stay in tune with evolving trends. In addition, it aims to optimise processes — both from a clinical and business perspective — leading up to efficiency in workflows and enhanced patient outcomes.

Referring to the opportunities at the Intelligent Health Pavilion, Pappas added: “We must note the existence of technologies that could further reduce the cost of healthcare, improve the delivery of care and enhance patient safety. It also gives accountability and helps eliminate errors, so that we can reduce risks. With technology, we are further able to improve the patient experience, which includes reduced hospital stays and readmissions.”

The Intelligent Health Pavilion featured the latest digital innovations and future-ready solutions presented by organisations from various sectors of the healthcare industry across the globe, giving medical professionals and investors an interactive playground to network and discover new-age treatments. Dubbed a ‘show within a show’, the pavilion also introduced visitors to live simulations in an emergency department, intensive care unit and operating theatre, where each enclosed space offers attendees an intimate audio-visual representation of live cases.

The leadership theatre, on the other hand, welcomed attendees to thought-provoking concepts led by seasoned experts in various fields. Each session also shone a light on the latest trends, addressed challenges, proposed solutions and demonstrated case studies of digihealth integration and solutions alongside success stories.

“We understand that different hospitals have different needs. We are very passionate about education and ensured that each session delivers real information and steer clear of brand and product promotions. We had some great presentations every day until February 2. I recommend dedicating a few hours during the Arab Health show in the future to learn more,” said Pappas.

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This article appears in the Daily Dose 2023. Read the full issue online today.

< Back to Technology

Could cells taken from a small patch of skin become heart muscle and repair a rare congenital heart defect? It's a scientific question that Timothy Nelson, M.D., Ph.D., and collaborators hope to answer for those born with an underdeveloped left heart chamber — a rare, complex condition known as hypoplastic left heart syndrome (HLHS).

Discovering the first cell-based therapy to rebuild heart tissue for HLHS has been a decade-long research passion for Dr. Nelson, who is the director of the Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome at Mayo Clinic.

"The problem is that the majority of complex single ventricle patients born with congenital heart defects, like HLHS, are going to eventually develop heart failure. Unfortunately, heart transplantation is less than ideal for this patient population, that can include children with complex comorbidities, even if there wasn’t a severe shortage of suitable organs," says Dr. Nelson. "Mayo Clinic research plays an important role in advancing innovative discoveries for rare and complex heart conditions to expand options."

Remuscularising the heart

Approximately 10,000 people in the U.S. are living with HLHS — a condition that severely weakens the heart. Surgery to reposition arteries enables a single ventricle to pump blood to the lungs and the rest of the body, but that restores only a portion of circulatory function. While advancements are being made, few people with HLHS live past the age of 30.

Timothy Nelson, M.D., Ph.D

"HLHS is essentially like taking your lawn mower engine and putting it into your Sport Utility Vehicle (SUV) and driving to work at 70 miles an hour every day," says Dr. Nelson. "Our research is trying to understand if we can convert defective hearts from a 5-horsepower engine to a 50-horsepower engine. We probably will never make it into the 100-horsepower engine that a normal heart is, but our goal is to make the heart bigger and stronger."

Current technologies in clinical studies, such as cord blood and bone marrow, which Dr. Nelson calls "fertiliser," can be injected into the heart muscle during planned surgeries and may be useful to preserve and protect the heart muscle. Ultimately, this has limited therapeutic value after the onset of heart failure.

"Fertiliser approaches may stimulate the heart to grow the best it can. That doesn't get us to the finish line most of the time because the fertiliser by itself just isn't able to grow it big enough and strong enough," says Dr. Nelson.

In search of new options, Dr. Nelson's research team is investigating whether a bioengineered heart product could regenerate the patient's own heart tissue and repair the underdeveloped part of the heart — essentially remuscularising the heart.

From patch of skin to a heart cell

Research into heart tissue regeneration begins with a biopsy of the patient's skin the size of a pencil eraser. Cells are extracted and then reprogrammed to become induced pluripotent stem cells, which is like turning back the clock in time to when cells were first forming in the womb. At that state, the cells are dividing and capable of becoming any type of cell in the body. In this case, they are then trained to become heart cells, known as cardiomyocytes. They become beating, contracting heart muscle cells.

It is a nine-month process from cell extraction to the scale up of the hundreds of millions of cells that would be needed to test whether they could form new heart tissue.

"We have reprogrammed these cells in the lab and tested them in multiple preclinical models where we observed them engrafting into the heart muscle of the recipient, then they grow, divide and expand," says Dr. Nelson. "We are now interested in learning whether these cardiomyocytes could regenerate heart tissue in humans."

Dr. Nelson's decade-long circuitous research path has led to an important nexus. The Food and Drug Administration will permit the team to study the safety of induced pluripotent engineered heart cells in a phase 1 trial at Mayo Clinic for adults with congenital heart defects.

The HLHS Consortium, comprised of multiple cardiovascular hospitals across North America, was founded at Mayo Clinic and provides a team approach to conduct large-scale studies for complex congenital heart disease patients. The HLHS Consortium works together to advance scientific knowledge and practice for rare congenital heart disease.

This important work — to repair, replace or restore diseased cells, tissue or organs — is associated with regenerative medicine. Mayo Clinic's Center for Regenerative Biotherapeutics supports HLHS research through distributing and expanding the network of scientists and researchers utilizing these tools at the Regenerative Medicine Biotrust.

This HLHS research milestone at Mayo is made possible, in part, by collaboration with Mayo Clinic Ventures to license the technology to a nonprofit organisation that will be sponsoring the clinical trial. The nonprofit organisation, HeartWorks, and its staff of 20 have worked with Mayo Clinic’s program for HLHS to co-develop technology that will be tested. The research is also supported by the generosity of the Todd and Karen Wanek Family.

Depending on the outcome of the phase 1 safety study, it could take years before engineered heart tissue is approved for use in daily clinical care for congenital heart disease.

 

About Dr. Nelson

Dr. Nelson graduated with degrees in biochemistry and molecular biology from the University of Wisconsin Eau Claire and Platteville. He completed the Medical Scientist Training Program at the Medical College of Wisconsin, followed by a research fellowship and residency at Mayo Clinic. He has additional training in cardiovasology through the National Institutes of Health.

 

Research by Dr. Nelson:

Single-Cell RNA-Sequencing and Optical Electrophysiology of Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes Reveal Discordance Between Cardiac Subtype-Associated Gene Expression Patterns and Electrophysiological Phenotypes

Stem Cell Therapy and Congenital Heart Disease

Tactile feedback is the next big area of focus as robotics gains popularity in the field of gynaecology. According to Dr. Saladin Sawan, Consultant — Gynaecology Oncology surgery, Department of Obstetrics and Gynaecology at Sheikh Shakhbout Medical City, who presented a session on “Robotic surgery in women’s health and how to integrate into UAE healthcare”, surgeons are increasingly turning to sophisticated devices for minimally invasive gynaecological procedures, which gives them enhanced precision, better manoeuvrability, magnified vision, clean incisions, confidence with surgical planes, less chance of organ damage and reduced complications. This has especially beneficial in procedures such as hysterectomy and those involving benign tumours, fibroids, and complex pelvic adhesions.

Dr. Saladin Sawan, Consultant — Gynaecology Oncology surgery, Department of Obstetrics and Gynaecology at Sheikh Shakhbout Medical City.

Unlike traditional surgery, there is an absence of tactile feedback in robot-assisted techniques, which is essential to ascertain the pressure on tissues during surgery.

“Tactile feedback is what is truly missing in the current system which would give surgeons a better sense of tension applied on the site. The data collected in real-time would be beneficial to reduce scar tissues during surgery,” said Dr. Sawan. This may potentially present a drawback in the adoption of technology and create a disconnect between healthcare providers and patients, he added.

While global efforts are underway to resolve this, robot-assisted surgeries are becoming more accessible and affordable across the globe, as more hospitals are investing in the acquisition of state-of-the-art devices for improved patient outcomes. A report by specialist researchers Markets and Markets notes that the global surgical robot market is poised to reach US$14.4 billion by the year 2026, which further supports this phenomenon. Other benefits include preoperative planning and warmup that are closely linked to high success rates.

Another factor aiding investments is the support provided by manufacturers in the industry, eliminating the significant costs involved in the implementation and maintenance of robots, said Dr. Sawan. The devices themselves are taking on a more mobile form with the addition of port, instruments, and carts to allow greater flexibility in procedures. Dr. Sawan added that robotics in gynaeoncology is expected to see faster progress and more robot adoption as the tariff for hysterectomies for endometrial cancer is higher than that of benign cases.

As technology evolves, Dr. Sawan said that healthcare providers must provide the right training for their doctors. “Honestly speaking, learning how to handle robots is not difficult to learn. It is like switching from your own car to driving another model. The difference is the willingness to adjust to the new car. A similar concept applies to moving from laparoscopic to robotic surgery,” he said.

Professionals need to give themselves time to settle into the new way of performing operations. “In the end, it is about clinical governance, and how we can deliver the appropriate procedure without increasing risks and complications,” he concluded.

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This article appears in the Daily Dose 2023. Read the full issue online today.

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